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Gender Competency Training for Medical Educators 28 th of April 2003 Evidence of gender difference and its clinical significance Ann-Maree Nobelius Faculty of Medicine, Nursing and Health Sciences Monash University Australia
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women are the major consumers of health care women are the primary decision makers in family health care women are the major consumers of prescription drugs
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2/3 of all pharmaceuticals used to treat both men and women have only been tested in men 2/3 of all diseases that affect men and women have only been researched in men women have only made up 7% of all cardiac research subjects
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more developed medical research systems in countries with white populations of European genetic origins greater levels of funding in these countries with white populations of European genetic origins the teratogenic risk associated with involving women in clinical trails while in their reproductive years and potential longer-tem outcomes for offspring
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Of these categories of difference gender is the largest and most obvious more than 50% of the world’s population are women more or less you are either one or the other on the basis of biological difference
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NIH in the US has recognised the significance of gender blindness in research and its clinical consequences instituted a policy of requiring research of disease that affect both men and women to include gender as a variable of research allocates funding in line with this policy resulting in increasing numbers of publications citing difference even where none is found This information has profound consequences for clinical practice
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Columbia University’s Journal of Gender Specific Medicine http://www.mmhc.com/jgsm/
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Some of the areas of difference that are important for clinical practice: Coronary heart disease Cardiovascular disease and arrhythmia Brain differences including number of neurons and plasticity Differential addiction times Responses to pain medication Eating and digestion Differential drug metabolism Differential treatment of dyslipidaemia Differential carcinogenic and toxic effects of tobacco smoke
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Differential risk of lung cancer Differential HIV viral loads and treatment options Depression from a genetic level Sex hormones and cognitive function Differential dietary treatment for obesity Gender differences in pre-pubertal children Differential lifetime medical costs Cataract Surgery Stress responses and the sympathetic nervous system (Taylor et al, in Psychological Review July 2000, Vol 107. No.3 p411-429)
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